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ADVANCE Perspective: Nurses

The Battle of Patient Diabetes Education: Where to Begin?

Published June 25, 2012 6:32 PM by Guest Blogger

By Katie Brind'Amour, MS, certified health education specialist and freelance health and wellness writer focusing on pregnancy and diabetes education.

One of the most difficult things about the growing body of Americans battling diabetes is how to educate them about daily life with the condition. How do you teach a patient about glucose meters, carb counting, the biology behind insulin resistance, hypoglycemia, basal vs. bolus, warning signs and complications, and meal preparation in the limited time available for an office visit?

Even specialized diabetes education classes can leave diabetic patients feeling overwhelmed and uninformed. Diabetes does, after all, require constant management and considerable commitment from the patient to successfully monitor and treat effectively. This type of incessant attention to blood glucose and dietary management is daunting to virtually every newly diagnosed diabetic, and doesn't get much less time-consuming with experience.

For most patients and health plans, however, continuous diabetes education courses - the kind that focus on a single topic in each class and are offered until a thorough, comprehensive and in-depth understanding of diabetes management can be engendered in attendees - are a distant dream. Instead, the world of information that fills entire volumes of medical books and scientific journals must be crammed into a 15-minute visit a few times per year, recited quickly to a stressed patient or omitted entirely to focus on a troublesome symptom or particular question.

The Digital Future of Diabetes Education

About 60% of all U.S. adults already search for medical and health information online, and with the advent of high-powered handheld Internet-capable tablets and phones that number is only expected to rise. Of those who use the Internet for health information, 66% search for disease-specific information, such as Type 2 diabetes management or complications.

Although there is a lot of unreliable (and downright dangerous) information floating around on the Net, nurses and doctors can do their patients a favor by helping vet online resources for them. Instead of leaving patients to their own devices - where they may click through questionable blogs and forums with unmonitored health advice exchanges - healthcare providers can collect a list of recommended sites to visit for trustworthy, detailed information on their health condition.

Referring patients to comprehensive health education sites for diabetes lets patients explore their new condition in the comfort of their own home and with the freedom of navigating to topics that concern them the most. Interactive and viewer-friendly sites even offer materials that are specifically designed for patient engagement and repeated use, incorporating pieces on everything from celebrities with the disease to diet plans to lists of questions for a doctor's visit. With online health education resources, patients can take their diabetes education at their own pace and in the amount of detail that they feel they require to manage their disease.

This is not to say that all education should be relegated to the Net, however - far from it. Instead, the Internet offers nurses and physicians the opportunity to give patients a gentle push toward a well-rounded, up-to-date diabetes education plan that they cannot offer in brief clinical sessions. Recommending a few great patient education forums and websites, and even using them as a jumping-off point for topics of discussion in office visits, can help health care providers work with patients in time-constrained situations, letting diabetes education be both patient-directed and patient-centered.

Incorporating Technology into Diabetes Management and Education

If a health facility has the capacity and the desire to become even more technologically savvy, it might even wish to consider e-visits for patient education and advice. Instead of spending the bulk of each visit checking vital signs, blood glucose, circulation, and anthropometrics, nurse educators and physicians can offer electronic consultations for quick questions and advice between standard visits by simply opening a laptop.

High-tech doctor's offices and hospitals are gradually welcoming e-consultations as a low-cost alternative to a full patient visit, and this type of check-in may be a simple solution for improved patient education. Diabetes education resources can be sent in quick text links to the patient - who must already be connected to the Internet to be able to participate in the webcam visit - and health professionals can answer questions on everything from insulin pump use to fast food menus.

As if e-visits weren't advanced enough, nanotechnology will soon help patients manage their blood sugar and vital signs with special contact lenses or mini implanted medical chips. Until these technologies are commercially available to automatically adjust insulin levels and alert medical staff to diabetic emergencies, however, health professionals will have to help their patients manage this disease the old-fashioned way: through education and self-empowerment.

These advancements in technology are amazing and have incredible potential for improved diabetes management, but without nurses and physicians committed to helping patients find high-quality, relevant, and accessible educational materials, all the nanotechnology in the world may not eliminate the dangers of diabetes. It's time for the health care world to keep up with its patients, and providing excellent online health resource referrals is an easy and responsible first step.

posted by Guest Blogger


I believe there is a difference between patient education and health information.  Health information is easily and appropriately shared on the Internet and other electronic media.  However, patient education refers to that which we health care providers identify as essential information for safe self-care.  This includes basic self-care skills, how to recognize a problem, how to respond, and answering any questions the patient has.  For example, I would not send a newly diagnosed insulin dependent diabetic off to the Internet to learn about the signs of hypoglycemia.  

Content that is appropriate for patient education is so important that the learner should teach it back to the health care provider, so the evaluation of understanding can be documented.

So yes, I agree, the game is changing.  I believe we should partner with patients, and individualize patient-centered care. I believe we should take full advantage of technology in this process.  But we must hold on to the essence of our responsibility, or it's a different game.

Fran London June 27, 2012 7:35 PM

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